Smile Revolution PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SMILE REVOLUTION PLLC

Practice address

2217 Olan Mills Dr
Chattanooga, TN 37421-1891

Phone

(423) 599-8363

NPI assigned

Sep 13, 2023

Last updated

Sep 13, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Peterson

Title

Financial Manager

Phone

(423) 472-6482

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily O'Hara, DDS

  • Dentist
  • Chattanooga, TN
  • NPI 1992356943
  NPD
• Bradley Logan Winn, D.D.S.

  • General Practice Dentistry
  • Cleveland, TN
  • NPI 1578741773
  NPD
• Lara M Fretwell, DMD

  • Dentist
  • Cleveland, TN
  • NPI 1407167950
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1194502088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 STUART XING NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 OLAN MILLS DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211891",
            "telephone_number": "423-599-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE REVOLUTION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "423-472-6482"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A Smallwood, CRNA
• Stacey Robyn Smallwood, PT
• Anna Smartt
• Deroneasha Smartt, LMSW
• McKenzie Brooke Smartt
• Melissa J Smith Vaughn, FNP
• Angela Smith-Slack, MD
• Aaron Christian Smith, FNP-C
• Abigail Smith
• Ally W Smith, SLP

• Dentist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.